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The resulting BMD correlates with bone strength and predicts fracture risk.[3] Therefore, DXA can be used to diagnose osteoporosis and to monitor patients on or off therapy.[9] Alternative screening tools, such as computed tomography-based absorptiometry, peripheral DXA and ultrasonography are not routinely recommended to diagnose osteoporosis or to monitor changes in bone density.[9] Osteoporosis risk factors should be assessed in all postmenopausal women. The National Osteoporosis Guideline Group recommends using the FRAX? (Fracture Risk Assessment) calculator (available online at www.shef.ac.uk/FRAX) to identify individuals at sufficient risk for fracture to warrant treatment or further evaluation by DXA. Using clinical risk factors, an individual's 10-year risk of major osteoporosis-related Resminostat fracture is estimated. Depending on the patient's age, body mass index and fracture probability, a recommendation is made to reassure the patient without further evaluation, pursue DXA selleck inhibitor for further refinement of fracture risk, or, in some cases, begin pharmacological therapy without DXA testing.[1] In contrast, US guidelines recommend DXA for all women 65 or older, or for younger postmenopausal women with major osteoporotic fracture risk greater than 9.3% by FRAX?.[3, 10] Generally, bone density testing is not recommended in healthy premenopausal women. However, adult women with certain medical conditions such as a history of fragility fractures, rheumatoid arthritis or glucocorticoid treatment can be learn more considered for bone density testing. Testing should also be considered for women with premature ovarian insufficiency who are not using estrogen.[3] DXA reports usually include assessment of the hip (total hip and femoral neck), lumbar spine or both. The National Osteoporosis Guideline Group (NOGG) recommends assessment of a single site with emphasis on the femoral neck, particularly in older people.[1] A forearm BMD may be useful in patients with hyperparathyroidism.[11] The BMD result is then compared with the mean BMD of a normal, young, gender-matched adult population (T-score) and to the mean BMD of an age, race and gender-matched population (Z-score). Osteoporosis is defined by a T-score